A soon-to-be-released study questions the safety of the popular procedure

We're in the middle of bikini season, which means many women are looking for easy hair removal options. Laser hair removal, which is offered in medical offices as well as in freestanding medi-spas and salons, has become a sought-after method. According to the American Academy for Aesthetic Plastic Surgery, laser hair removal was the third most popular nonsurgical aesthetic procedure (after Botox and hyaluronic acid fillers) in 2012, totaling more than 1.2 million treatments. But a new study puts its safety into question.

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This past May at the American Society for Laser Medicine and Surgery's annual meeting, Dr. Gary S. Chuang, dermatologic surgeon at Tufts Medical Center in Boston, reported the preliminary results of a study he conducted that demonstrated that laser hair removal releases potentially harmful toxins into the air. Chuang and his research team are analyzing the final pieces of data this week, and then the study will be published in a medical journal shortly thereafter.

It's the type of study that could single-handedly change the industry, but Chuang's colleagues reacted with skepticism when he first spoke about his desire to study the foul-smelling black smoke plumes he encountered every time he performed a laser hair removal procedure, which he estimates he does about 20 times a week.

"Initially people said, 'Ah, it's just sulfur,' because that's one of the main components of hair. There's a disulfide bond between keratin that makes your hair curl and builds up the bond within the hair," Chuang told us. "That seemed to make sense. But the black plume that comes out [during the procedure] was unsettling. And I found all these chemicals that were shocking."

He and his team discovered 300 different chemical compounds in the plume, 13 of which have been shown to be harmful to humans and animals, like benzene, toluene, ethyl benzene, and diethyl phthalate. These results are consistent with previous studies that demonstrated that using ablative CO2 lasers and heat cauterization in operating rooms releases mutagenic substances into the air. There are even documented cases of two health care workers contracting HPV of the throat, presumably—although it can't be conclusively proven—from breathing in viral particles (ick factor alert!) that were released into the air after they assisted on genital laser surgeries. So we already know that laser skin procedures can release some nasty stuff into the environment.

But what exactly are the health implications? Right now the biggest risk is potentially to the practitioners who perform these procedures and are exposed to the plumes frequently. It's important to note that no documented cases of cancer or other devastating illnesses have been associated with laser hair removal at this point, but it's something that the industry is just beginning to discuss. "A colleague mentioned that every time we had a hair removal, it seemed to trigger his asthma," Chuang told us. "What's concerning is that the 'dust' particles are small enough. When you breathe them in, they can irritate your airways, and the smaller the particle is, the deeper down it travels." In any case, this needs to be studied more before doctors can link these toxic substances to future disease.

In the meantime, dermatologists are concerned. Things like evacuators, which are heavy-duty suction machines, and certain kinds of masks can filter out most of the substances, but some still escape into the air. And not all medical practices use these devices for standard laser hair removal.

Dr. Elizabeth Hale, a clinical associate professor of dermatology at the NYU School of Medicine, who practices at the Laser and Skin Surgery Center of New York, already uses smoke evacuators and surgical masks during laser hair removal procedures, but hopes the industry provides better options. "None of it is perfect right now. I'm assuming there's going to be a move toward getting better filtration masks, but obviously they're more expensive and not readily available," she said. She also hopes the onus is put on the laser manufacturers to provide smoke evacuators in the future as part of the purchase of a laser.

Dr. Carolyn Jacob, the founder and medical director of Chicago Cosmetic Surgery and Dermatology, said that physician assistants perform laser hair removal at her practice, but they don't use evacuators or masks at this point. She's trying to look at the situation rationally, though she is considering changing her practice.

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"To be honest, I haven't made any changes in my office only because past history has shown us it hasn't caused any negative effects. I think if it were really going to show a true toxicity, we would have seen it by now," said Jacob, who has been performing laser hair removals for about 14 years. "These toxins most likely occur in our city [Chicago] anyway because of car exhaust and cigarette smoke. However, I think it would be wise to use a smoke evacuator. I think it would be wise to have your laser techs wearing a laser mask."

And what about you, the patient, who just wants those annoying tufts of bikini line hair gone forever? The good news is that you're probably the one at the least risk of exposure, since you're in there for such a short period of time, so you needn't go au natural just yet. However, you should absolutely feel free to ask for a mask if you're worried. Just know that standard surgical masks, the kind that tie around the back of your head or slide over your ears, won't be fully protective. There is a specific filtered mask called a laser mask that doctors wear while performing more ablative laser treatments, but again, be aware that not all practices have these masks available and they aren't completely airtight either.

All the doctors we spoke to noted that the industry is relatively unregulated, so you should be really careful about where you choose to get your hair removal done. Medi-spas and salons often offer laser hair removal much cheaper than at doctors' offices, but the staff is often not well-trained or experienced—and safety is a key concern. Many of these locations also probably don't use filtration and evacuators. "It's not a requirement for salons to have these evacuators," Chuang said. "HEPA filter vacuums don't come with the device. It's an additional purchase and they're quite expensive." Toxic smoke plumes aside, Jacob has seen many patients with burns and permanent scarring thanks to salon hair removal. So your best bet is always a board-certified physician's office.

Watch this space for future information, which will doubtless be forthcoming after Chuang's study is published. "I'm trying to promote awareness, not alarm, but I think we may just be finding the tip of the iceberg," Chuang said. "Once we start looking into it, there may be other things we didn't know existed."